The urethra is a tube through which urine, stored in the bladder, is passed outside the body. A urethral stricture is an abnormal area of constriction along the length of the urethra that reduces or obstructs the flow of urine. It is more common in males as the urethra is longer, passing through the penis and prostate gland.
Urethral strictures usually occur due to inflammation and scar formation in the urethra. This can occur with the introduction of penile implants, catheters, previous surgery to the urethra, prostate surgery and injuries close to the scrotum. Those with enlarged prostates and sexually transmitted disease such as gonorrhoea and syphilis have an increased risk of developing a stricture.
The symptoms that accompany a urethral stricture include:
- Reduced urine output or inability to urinate
- Weak stream
- Urethral discharge
- Pain during urination or in the pelvic or lower abdominal region
- Incontinence (inability to control urine)
- Swelling of the penis
- Blood in the urine
When you present to the clinic with these symptoms, your doctor will review your medical history and perform a physical examination of the penis or tissue overlying the urethra for swelling, redness and hardened areas. Urine flow is also evaluated. Urine tests are performed to determine the presence of infection. The opening of the urethra is measured and a cystoscope (lighted tube with a camera) may be inserted to examine the urethra and bladder.
The main treatment for urethral strictures is dilation. This is accomplished by first introducing a narrow dilator, followed by successively larger ones to gradually dilate the urethra. Your doctor may recommend an urethroplasty, an open surgical procedure to treat severe strictures. This involves removing and reconstructing areas of stricture. In rare cases, where urethral flow cannot be re-established, a urinary diversion is created to redirect urine outside the body through the abdominal wall.